Class Registration Form

Name   

Address 

Phone: day  eve 

10515 East OP Ave
Scotts, MI 49088
USA
Phone: 269/626-0223
Fax:  269/626-0226

Class Title

Class No.

Begin Date

No.
Persons

Fee

Totals

Enter Class Fees SUBTOTAL here and on Line 1 below.  $

office use only

id

ck#

date

conf

bal

acct/class copy

Enter Class Fees SUBTOTAL - Line 1 

Subtract discounts: family 10% or multiple registration 5% - Line 2  ()

If a Tillers Member, subtract 10% of Class SUBTOTAL - Line 3  ()

Combine Lines 1 through 3. Total Class Fees - Line 4 

Add 30% (X .30) of Line 4 for minimum deposit - Line 5 

Add first nights lodging deposit: bed $40, room $65 - Line 6 

Tillers' Membership, $40 per year - Line 7 

Total Payment Enclosed - combine Lines 5 through 7.  $